2024-03-01 06:41:15
(Quebec) The coming and going of specialist doctors between the public and private systems, “we don’t like that,” says the president of their federation, Dr. Vincent Oliva. But curbing this practice as the Legault government wants to do would have “negative effects”, according to him.
Updated March 1
What there is to know
More and more doctors are commuting between the public and private sectors.
In the private sector, they operate on patients who are willing to pay thousands of dollars to avoid waiting in public.
Quebec plans to slow down this back and forth by tightening the rules.
The Federation of Specialist Physicians does not encourage this practice, but fears the effects of a tightening.
In an interview, the president of the Federation of Medical Specialists of Quebec (FMSQ) affirms that he was not consulted by the government, but that he was nevertheless informed of the existence of a “draft regulation” prepared by Quebec to tighten the rules.
“Yes, now I know there is a draft regulation. Absolutely. But we didn’t see it [et] we didn’t analyze it,” he says.
The government plans to extend the deadline for disaffiliating with the Régie de l’assurance santé du Québec (RAMQ) from 30 to 180 days – approximately six months. Such an extension of the notice period would prevent any doctor from commuting between the public plan and the private sector several times a year.
Currently, to leave the public plan, a doctor only has to send a notice to the RAMQ and wait 30 days. After this one-month period, he becomes “non-participant” in the public plan and can begin practicing privately, where patients are willing to pay thousands of dollars to have surgery and avoid waiting lists. To become a “participant” in the RAMQ again, simply send a new notice to the state society, and the doctor can resume public practice eight days later.
« Malaise »
Over the past ten months, 137 doctors – almost all of them specialists – have temporarily left the public system more than once to work in the private sector. That’s double from five years ago.
This is not the kind of practice we encourage. We would prefer that she not be present.
Dr. Vincent Oliva, president of the Federation of Specialist Physicians of Quebec
Two elements cause “discomfort” according to him. First there is “an ethical issue”: a doctor suggests to his patient that he sees in the public network to operate privately more quickly. “A doctor refers a patient to himself” and makes “financial gain,” emphasizes Dr. Oliva.
The other issue “is the importance of the costs for patients”. “Patients have to pay money out of their own pockets, and I feel uncomfortable about that. »
But should this practice be curbed? Dr. Oliva wonders. “We have to look at the pitfalls or the potential negative effects of making it more difficult, the in-and-out. »
Affected doctors will not necessarily obtain more operating time in the public network, since access to technical platforms is limited, he argues. And patients, who could have less access to the private sector to have surgery at their own expense, “will clog up the waiting lists even more”.
« […] It can be annoying,” a “two-speed” medicine, but this second speed, which is certainly not desirable, still gives oxygen at the first speed. […]. It’s a relief,” he argues.
“The Root of a Problem”
A tightening of rules could also cause an exodus towards the private sector. “I don’t want this in-and-outbut if some of these doctors had to choose to go completely into the private sector, we would miss the objective. […] It would be worse. »
Dr Oliva calls for a “nuanced debate” on the issue, especially since the number of doctors concerned is “marginal” despite the increase observed in recent years.
“It’s not the root of a problem, it’s the consequence. These doctors do it because the public network does not offer them the capacity to provide care. Let’s work to improve the public network so that we don’t need this type of valve. » But increasing access to technical platforms and operating rooms “does not seem realistic in the short term”, according to him.
The office of the Minister of Health and Social Services, Christian Dubé, neither confirms nor denies the existence of a draft regulation to slow down the comings and goings. He says he is “still at the thinking stage”.
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